Health Outcomes Consultant
Cambia Health Solutions

Job Info

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HEALTH OUTCOMES CONSULTANT

Telecommute Option - Must reside in ID, OR, UT or WA

WHO WE NEED

Directs in the development of analytic support and reporting capabilities to facilitate the implementation and operation of medical management programs and initiatives to impact medical claim costs. Supports the creation of executive reporting for health care services programs and clinical leaders.

Normally to be proficient in the competencies listed below

The Health Outcomes Consultant would have:

• Bachelors degree in business, finance, IT or related field or equivalent education and experience. Masters is preferred.
  
• Five years of experience preparing financial or medical trend analyses for executive review is required.
  
• Five years experience in health care services analytics such as reimbursement review, clinical coding review or medical claims cost trend review is required.
  
• Must have a strong understanding of health care services and a solid understanding of finance and IT business areas.
  
• Knows business goals, organization, mission, strategic interests, priorities, processes and issues.
  
• Experience in report writing with graphic and statistical elements that supports recommendations and facilitates strategic decision making.
  

Preferred Key Experience:

• Demonstrated project management skills in effectively managing multiple projects, clients, and deadlines.
  
• Demonstrated excellence in analytic and quantitative skills.
  
• Demonstrated excellence in written communication skills and techniques as well as strong influencing skills.
  
• Ability to effectively communicate with a broad section of internal and external stakeholders including executive management, purchasers, outside consultants and providers.
  
• Ability to apply and interpret quantitative data for decision-making.
  

YOUR ROLE:

• Directs and performs the production of timely and accurate research, analysis, and recommendations with respect to medical management effectiveness analysis, measurement, and reporting.
  
• Engages with clinical leaders and SMEs to drive the development of research, analysis, and recommendations for pursuit by a clinical services or medical director team
  
• Supervises the gathering and analysis of information related to health care services performance reporting.
  
• Creates and maintains executive reporting in order to communicate the value of medical management programs.
  
• Meet regularly with medical management business subject matter experts to understand reporting needs and priorities
  
• Retrieves complex data sets from internal systems to support on-going activities and meet measurement requirements and data needs.
  
• Responsible for coordination timely and accurate research, analysis, and recommendations with respect to medical claims cost trend.
  
• Assist HCS with initiation and operation of integrated medical management
  
• Evaluate medical management impact through the engagement of key stakeholders in Medical Services, Provider Services, Member Services and Product Development.
  
• Active involvement in key internal initiatives that are dependent on performance measurement analysis and external local and national performance measurement programs and benchmarks.
  
• Communicate medical management performance on success and value factors. Applies an understanding of medical management programs, medical operations, member and provider appeals, and other mechanisms that impact the cost and revenue structures within Regence.
  
• Serves as a department-wide resource on program evaluation and measurement.
  

WHAT YOU BRING:

• Customer Focus: Is dedicated to meeting the expectations and requirements of internal and external customers; gets first-hand customer information and uses it for improvements in products and services; acts with customers in mind; establishes and maintains effective relationships with customers and gains their trust and respect.
  
• Integrity and Trust: Is widely trusted; is seen as a direct, truthful individual; can present the unvarnished truth in an appropriate and helpful manner; keeps confidences; admits mistakes; doesn't misrepresent him/herself for personal gain.
  
• Drive for Results: Can be counted on to exceed goals successfully; is constantly and consistently one of the top performers; very bottom-line oriented; steadfastly pushes self and others for results.
  
• Problem Solving: Uses rigorous logic and methods to solve difficult problems with effective solutions; probes all fruitful sources for answers; can see hidden problems; is excellent at honest analysis; looks beyond the obvious and doesn't stop at the first answers.
  
• Collaborative facilitator: Identifies key stakeholders and subject matter experts needed for a body of work and engages them successfully to drive results. Able to balance the role of convener with the need to provide firm guidance to diverse groups of business partners and SMEs.
  
• Learning on the Fly: Learns quickly when facing new problems; a relentless and versatile learner; open to change; analyzes both successes and failures for clues to improvement; experiments and will try anything to find solutions; enjoys the challenge of unfamiliar tasks; quickly grasps the essence and the underlying structure of anything.
  
• Strategic thinking: Able to consider multiple different angles to a given topic and consider potential implications of actions and/or account for short- and long-term factors to a given piece of work. Brings others along with them in their thought process and quickly adapts to and accounts for new input or information.
  
• Population health focused: Demonstrated experience working with health care leaders to drive impactful actions that improve the collective health of a population.
  
• Proactive analyst: Demonstrated experience providing clinical experts with valuable, directionally-appropriate insights and/or in providing the framework for which a clinical SME can quickly provide expert input and guidance.
  
• Business Acumen: Knows how businesses work; knowledgeable in current and possible future policies, practices, trends, and information affecting his/her business and organization; knows the competition; is aware of how strategies and tactics work in the marketplace.
  
• Planning: Accurately scopes out length and difficulty of tasks and projects; sets objectives and goals; breaks down work into the process steps; develops schedules and task/people assignments; anticipates and adjusts for problems and roadblocks; measures performance against goals; evaluates results.
  
• Priority Setting: Spends his/her time and the time of others on what's important; quickly zeros in on the critical few and puts the trivial many aside; can quickly sense what will help or hinder accomplishing a goal; eliminates roadblocks; creates focus.
  
• Presentation Skills: Is effective in a variety of formal presentation settings; one-on-one, small and large groups, with peers, direct reports, and bosses; is effective both inside and outside the organization, on both cool data and hot and controversial topics; commands attention and can manage group process during the presentation; can change tactics midstream when something isn't working.
  
• Functional / Technical: Skills Has the functional and technical knowledge and skills to do the job at a high level of accomplishment.
  

The base pay annual salary range is: 91.5k-149k

The bonus target for this position is 15%

At Cambia, we take a variety of factors into account when creating a job offer, including your skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. While we offer competitive salaries, in general, we rarely hire candidates at or near the top of the salary range.

Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current. Some highlights:

• medical, dental, and vision coverage for employees and their eligible family members
  
• annual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)
  
• paid time off and company holidays
  
• up to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period)
  
• up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)
  
• one-time furniture and equipment allowance for employees working from home
  
• up to $225 in Amazon gift cards for participating in various well-being activities for a complete list see our External Total Rewards page.
  

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers site.

This job has expired.